Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | CG61232459 | WA |
N | 103K00000X | Behavior Analyst |
NPI | 1003458894 |
---|---|
Provider Name | Ena Valjevac |
First Address | Vancouver, WA 98661-3713 |
Second Address | Vancouver, WA 98661-3717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2019 |
Last Update Date | 07/10/2021 |